Series: How Communication and Technology are Changing the Faces of Africa
(Brooklyn, New York) “Africa is rising” is becoming an increasingly common saying among economists and development groups. But, for many of us in the West, this phrase is both vague and confusing. When we interact with a continent that many of us are only familiar with in terms of mass poverty, disease and war, it is difficult to understand why, for instance, we would pay attention to the development of mobile technology in Africa when so many are still lacking in basic necessities such as food and water. Beyond that, does a “rising” Africa have anything to offer Western markets and and industries?
The following series is an exploration of what the growth of information and communications technology in Africa is changing across the continent and the way this growth intersects with the priorities of the Western world. The series will begin with the development of mobile phone applications and the way they have affected patient care in Kenya and Malawi, among other countries. This piece will also dissect the way mobile health innovation in Africa could affect health care across the globe. The pieces afterward will discuss information and communications technology and gender issues, followed by agriculture and the shift toward large scale production available with growth in mobile applications. Lastly, this series will focus on virtualized jobs and specific African countries that could be key to many Fortune 500 companies in the years to come, along with the policy reform and governmental support of technology that could be a large factor in the growth of individual countries in Africa.
When his work brought him face to face with some of Malawi’s poorest, Isaac Holeman found that many who could not afford food were investing their money in basic technology.
“You have people that don’t have access to, and may not have, three square meals a day…but they’re investing their own money in mobile phones and airtime,” Holeman, chief strategist at Medic Mobile, commented. “Very poor people will pay money for services and be very excited about the service they’re getting. It’s worth it to spend money on stuff that helps you.”
Medic Mobile is a nonprofit organization creating text messaging platforms for health systems in Africa, Asia and Latin America. Many of those working for the nonprofit say they have seen the implementation of a simple text messaging application change the outcome of a patient’s treatment. Holeman shared the example of an application discerning the difference between a woman not showing up to her medical appointment because she had to go to market, or delaying her trip because her son was urgently sick with malaria and needed a visit from the hospital staff. Kenyan developer Jonathan Mativo, who works as a field project manager for the nonprofit, also said that he has seen text messaging applications be crucial to safe childbirth when caregivers were able to get in touch with expectant mothers.
“I wanted to know if SMS could make or bring in any social change,” Mativo remembers. “I have stories where an SMS has changed a woman’s life who was delivering.”
In Malawi, Medic Mobile reports 100 patients starting TB treatment within the first six months of their pilot program, after their symptoms were noticed by community health workers and reported by text message. Beyond reaching previously unreachable patients, applications are also saving clinics and hospitals a significant amount of money. Medic Mobile’s pilot program in Malawi saved hospital staff 1200 hours of follow-up time and over $3,000 in motorbike fuel within their first six months of operation.
The implementation of mobile telecommunication and multimedia technologies into healthcare delivery systems has been termed “mHealth” by The Center for Global Health and Economic Development at Columbia University, as well as health care professionals across the globe. Kate Otto, a World Bank public health consultant, said she believes the necessity of this type of technology in the developing world will drive them to innovate beyond the developed world in terms of mobile applications.
“Those who may urgently need better services are also increasingly empowered to do something about it,” said Otto. “A friend of mine who is living with HIV just this week shared with me a new online and mobile tool she built, customized for her home country, a developing nation, that identifies all HIV clinics and services in a particular area and allows patients to give facility reviews. It’s like Yelp for HIV/AIDS care, which is hugely useful amidst still-high levels of discrimination. Since she needs this service herself and she has the skills to do so, it seems quite natural that she built it.”
Because innovation in Africa is driven by a deep need for new methods of communication and work, it has introduced new forms of efficiency in the way technology is used. In contrast to the proprietary focus of technology in the West, Holeman said the innovation in Africa’s mHealth sector has focused on human objective: how to get people to lead healthier, better lives.
The applications that are developed also have a unique potential to reach developing countries across the globe because they are primarily geared toward $15.00 mobile phones.
“Folks are creating local applications that respond to local development’s challengers, but that have a global appeal,” said Laurent Besancon, World Bank’s program coordinator for ICT, Africa region.
Besancon gave the example of Ushahidi.com, a Kenyan website that created a google map from eyewitness reports of violence following Kenya’s 2007 election after they were sent in by email and text message. Because the application was adaptable to other situations with the need for aid reach in a disaster management situation, Haiti and Pakistan both implemented the tool afterward.
African developers and computer scientists are also providing channels for UNICEF, World Bank and USAID, among others, to expand their reach to rural or remote areas. Text to Change, a Ugandan initiative that presents organizations with scalable mobile platforms, is one such avenue.
“They come up and say, ‘we need to reach out to maybe expectant mothers in these districts, and we need to reach out to them using the mobile phone with information say on antenatal, PMTCT [Preventing Mother to Child Transmission] or nutrition’” said program Manager Maureen Agena. “So we get a database, or we use other media, like radio, to reach our target group.”
Agena gave the example of an organization looking to target pregnant mothers and encourage them to go for antenatal visits. Text to Change often utilizes local media, such as radio, to advertise to women in rural areas and ask them to text in a code to voluntarily opt in to receive reminders concerning their appointments and checkups. She said she has found that a huge numbers of women voluntarily opt in to this kind of service. The nonprofit is also able to cut across literacy levels through sending out voice recordings - a tool Agena said has been particularly useful.
The continent’s most promising work is coming out of Kenya, where Mativo said his work is part of a shift toward Africans taking information and communication technology development into their own hands.
“We have the resource of ideas in Africa and many young people are coming up with ideas that are really going to change things in Africa,” he said. “We are already taking development on our own.”
East Africa’s Seacom cable connected many countries on Africa’s East coast from South Africa to Europe via the Red Sea for the first time in 2009. According to Besancon, Kenya has since shone as a leading example of ICT innovation on the ground, with around 1700 application developers on the ground - a number unheard of anywhere else in Africa. He said he believes Kenya’s groundbreaking position is credit to the government’s commitment to creating a conducive environment for innovation, in contrast to the over regulation of tech innovation in some African countries. Kenya’s government has encouraged innovation both through ICT policy reform and the support of innovation labs across the country. While Kenya is leading the way in ICT development, Ghana, South Africa, Rwanda, Kenya and Senegal are also major hubs for tech, along with Tanzania, a country Besancon says is on the rise.
While their target population lives in rural and impoverished communities, the clients funding applications like those produced at Medic Mobile and Text to Change include some of the world’s largest health organizations. Jonathan Jackson, CEO of Dimagi, a social enterprise that makes open source software to improve healthcare in developing countries, said innovation on the ground is often funded by organizations looking to change global healthcare issues - partly because looking to local talent has proven to be much more affordable than outsourcing.
“To be cost effective you need to either not innovate or innovate locally,” Jackson said.
This search for local tech talent for mHealth development is what Holeman said is partly responsible for growth in Africa’s ICT sector.
Otto also explained that the cultivation of this kind of local talent for the promotion of mHealth projects is key to the success of health programs on the ground.
“Take our mHealth study in Ethiopia. Our local Ethiopian software developers and network administrators have been the centerpiece of enabling our program to function despite difficult circumstances,” Otto said. “Nothing can replace being from a country and understanding deeply the cultural, political, and social complications that could trip up a project if one is not mindful.”
Henok Getachew, a software engineer at John Snow, Inc., laughed as he commented on the Western perception of technology and its developers and engineers in Africa. Citing Jamie Uys “The Gods Must Be Crazy” as an example of the Western perception of his continent, he said he hears about Americans and Europeans being surprised to find tech talent and innovation on the ground in Africa. These people, Getachew commented, have a prejudice about what Africa is, and what she needs in order to move forward as a continent - both in the basic supply of necessities, and as a lasting economy.
“If you just give someone clean water, they’ll just have clean water to drink, but then what will they do with their life?” Getachew said. “This goes into enabling Africans to prepare for themselves - as much as aid goes, I mean, aid might be a good thing but, in some respects, then, just like that saying, ‘you feed someone a fish he eats for a day, but you teach someone to fish and he eats for a lifetime.’”
Editor’s Note: Shanley Knox manages a social enterprise building the capacity of female artisans in rural Uganda. She spends several weeks in southern and central Uganda each year.
Series Schedule: Part 2 of How Communication and Technology are Changing the Faces of Africa will be published on September 11, 2012.